The effect of clinical face shields on aerosolized particle exposure

Background: Face shields protect healthcare workers (HCWs) from fluid and large droplet contamination. Their effect on smaller aerosolized particles is unknown. Materials & methods: An ultrasonic atomizer was used to simulate particle sizes equivalent to human breathing and forceful cough. Particles were measured at positions correlating to anesthetic personnel in relation to a patient inside an operating theatre environment. The effect of the application of face shields on HCW exposure was measured. Results & Conclusion: Significant reductions in particle concentrations were measured after the application of vented and enclosed face shields. Face shields appear to reduce the concentration of aerosolized particles that HCWs are exposed to, thereby potentially conferring further protection against exposure to aerosolized particles in an operating theatre environment.

3D printed models decentralise surgical skills training for retrograde intrarenal surgery and percutaneous nephrolithotomy in the COVID-19 era

Introduction & Objectives: Imparting the required psychomotor skills for trainees to become proficient in Percutaneous Nephrolithotomy (PCNL) and Retrograde Intrarenal Surgery (RIRS) is tricky for surgical educators, due to the challenging nature of the procedures and the lack of realistic simulators. The current COVID-19 pandemic has compounded these issues by reducing learning opportunities for trainees through reduced case numbers and availability of surgical skills courses. To address these contemporaneous issues, we have developed 3D printed inexpensive combined RIRS and PCNL training models for both in-person and video conference skills training. Materials & Methods: Anonymised Computed Tomography data was used to develop the training model, using medical image processing software (3D Slicer, version 4.12, Harvard, USA). The model was 3D printed using flesh-coloured resin which best approximated the appearance of the collecting system during ureteroscopy. The face validity of the simulator was assessed by surgical educators for its suitability for both in-person and remote training. Results: The RIRS and PCNL training model was evaluated by expert Urologists involved in the national training of the procedures and found to be more realistic and affordable when compared to available alternatives. The 3D printed model was developed for under €3, allowing multiple identical copies to be 3D printed for both in-person courses and scheduled video conferencing workshops with the models distributed to each participating centre beforehand. This “hub and spoke” method of surgical skills training is greatly facilitated by the affordability of the 3D printed models. Conclusions: We have developed an inexpensive combined RIRS and PCNL training model for both in-person and remote training at USANZ and other international training courses. 3D printed simulators have great future potential in the training of endourological and other urological procedures, enhancing connectivity and facilitating the decentralisation of training courses for the acquisition of key surgical skills.